Handsewn Bowel Anastomosis: Photo Layout

"Handsewn Bowel Anastomosis Model 1 Model/2 Students SUPPLIES NEEDED: MODEL: 1-1"x18" Penrose drain cut in half 1-Small blue plastic surgical tray from OR packs 2-Small office clips 1-Blue towel for base 4-Blue towels for draping 2-Pieces of felt fabric 2 ¾" x ¾" per resident 3-4 4"x4" tiles for weight 1-Skin Stapler Any suture Craft Scissors Needle holder INSTRUMENTS: 2-Toothed debakeys 1- Needle Holder 1-Scissor 2-Mosquitos SUTURE: 3-0 Silk on SH/V-20 3-0 or 4-0 vicryl or PDS on a taper needle INSTRUCTIONS TO BUILD: 1. Gather supplies 2. Mark the middle of the Penrose and cut in half 3. Cut 2 pieces of felt to above specified measurements 4. Tack ends of felt with suture so felt forms a circle 5. Place circle of felt on the inside ring of the Penrose-felt should fit perfectly inside Penrose without gaps or folding up on itself 6. Trim if necessary 7. Place 3 or 4 tiles on blue tray to provide weight/keep tray from sliding 8. Lay towel across base of tray 9. Attach Penrose to each long side of the tray so that ends with felt are matched up in the center of the tray 10. Block drape and use skin stapler to create a window showing only the felt-centered Penrose drain 11. When one resident has completed the anastomosis, use scissors to cut out completed portion. 12. Adjust portion of penrose with clip and insert new felt pieces for next resident CAN BE USED FOR: ACS/APDS Surgical Skills Curriculum for Residents-Phase 1 Module 19-Hand Sewn Gastrointestinal Anastomosis."

HAND SEWN BOWEL ANASTOMOSIS UNIVERSITY OF UTAH SURGICAL SKILLS LAB Peter Bartline MD, Ruth Braga MSN, William Peche MD, Daniel Vargo MD 1.Gather Supplies 2.Mark Middle of Penrose & Cut. Cut Felt To Specifications 3.Tack Felt With Suture To Form A Circle 4.Place Circle of Felt Inside Penrose University of Utah Surgical Skills Lab-Hand Sewn Bowel Anastomosis Model 5.Lay Tiles & Blue Towel On Tray 7.Drape University of Utah Surgical Skills Lab-Hand Sewn Bowel Anastomosis Model 6.Clip Penrose To Sides Of Tray